Assessment
Questionnaire

Insomnia Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the
symptom: Insomnia. These will include a physical examination and possibly diagnostic
tests. (Note: A physical exam is always done, diagnostic tests may or may not
be performed depending on the suspected condition)
Your doctor will ask several questions when assessing your condition. It is
important to openly share any pertinent information to help your doctor make an
accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all
medical conditions, medications including dosages, and names of numbers of any
specialist you see.

Why: Common problems with the sleeping environment that may contribute to insomnia and sleep disturbance include noise, extreme temperatures, poorly ventilated room, hot bedroom, cold bedroom, mattress that is too soft or hard, too much light in bedroom.

Do you take day time naps?

Why: may cause or prolong the problem of insomnia.

What is the age of the person with insomnia?

Why: a reduction in sleep requirements often accompanies aging. If the sleep disturbance is in a child or infant must consider hunger, colic, indigestion, dirty diaper, too hot, too cold, teething.

Why: questions specifically about relationship, family, children, social support, occupation, general physical health and financial stresses. Stressors are a common cause of insomnia such as a change of occupation, loss of a loved one, illness, anxiety over a deadline or examination.

Previous or current use of sedatives or hypnotics?

Why: The regular use of sedatives or hypnotics will interfere with sleep patterns and lead to chronic insomnia. Often the dosage of these medications will have been increased in the past so as to maintain hypnotic effectiveness after tolerance begins to develop. In cases of withdrawal, individuals may sleep only 1-4 hours each night ("rebound insomnia") for several weeks and will also experience an increase in anxious dr and nightmares and awakenings through the night.

Why: may cause insomnia especially at bedtime. The use of nicotine patches for smoking cessation may cause vivid dreams and disturbed sleep in some people.

Alcohol history?

Why: excessive alcohol before bedtime may cause insomnia. Typically alcohol causes increased drowsiness and reduced time to fall to sleep but even moderate amounts of alcohol can increase awakenings after sleep onset by interfering with the ability of the brain to maintain sleep.

Caffeine intake?

Why: including coffee, tea, cola, chocolate (especially before bedtime but even in the afternoon in some people) may cause insomnia. It causes an increased time to fall to sleep, more frequent arousals during sleep, and a reduction in total sleep time for up to 8-14 hours after caffeine ingestion.

Why: causes of night time urination such as cystitis, prostatitis, benign enlargement of the prostate, prostate cancer, diuretic usage and diabetes may effectively cause insomnia due to the practical need to urinate.

Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), increase or decrease in appetite (usually decreased), weight loss or gain, insomnia or increased sleeping, fatigue, loss of energy, feelings of worthlessness, feelings of excessive guilt, poor concentration, difficulty making decisions, low libido, thoughts of death or suicide attempt. The great majority of individuals who experience major depression will suffer form insomnia, usually early morning wakening (usually around 3am) with difficulty returning to sleep.

Why: e.g. nervousness, shakiness, tremor, restlessness, irritability, insomnia, poor concentration, heart palpitations, racing heart, sweating, dizziness, diarrhea, lump in throat and frequency of urination. Difficulty with getting to sleep (both at the beginning of the night and following night time awakenings) is a common feature of generalized anxiety disorder, due to increased autonomic arousal and worry.

Why: e.g. irresistible urge to move their legs when awake and inactive, especially when lying in bed just prior to sleep. This interferes with the ability to fall asleep. People experience a creeping, crawling sensation deep in their calves that is only relieved by movement, particularly walking.

Why: e.g. coarse hand tremor most marked at rest, rigidity of limbs, slowness in initiating and executing movements and speech, expressionless mask-like face and dementia. Sufferers of Parkinson's disease frequently complain of difficulty getting to sleep and increased awake time during the night.

Conditions listing medical symptoms: Insomnia:

The following list of conditions
have 'Insomnia' or similar
listed as a symptom in our database.
This computer-generated list may be inaccurate or incomplete.
Always seek prompt professional medical advice about the cause
of any symptom.

Select from the following alphabetical view of conditions which
include a symptom of Insomnia or choose View All.

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